WillSpirit

Where Will meets Spirit
∞ A Blog Devoted to Balance, Peace, and Clarity ∞

A formerly depressed physician tells stories of trauma, grief and recovery, and offers suggestions for emerging from darkness, living with mood swings, and awakening to life.








  • Red_Exclamation_DotDisclaimer
    • Dear Visitors:
      Although I trained and practiced as a physician, my background does not include formal instruction in psychiatry beyond basic medical education. This journal presents ideas about treatment philosophy, but must not be considered therapeutic advice. Abrupt changes in one's psychiatric medications can trigger profound cognitive, emotional, and physical symptoms, including suicidal thoughts and actions. Consequently, pharmaceutical agents should not be increased or decreased without supervision by a mental health clinician.

    • ON THE OTHER HAND, your brain belongs to you, and your opinion counts. If you decide that changing your medication regimen will serve your best interest, then I believe your providers have an obligation to help you try to achieve your goals. I want everyone to be educated about their options, and do what will be most helpful for themselves. No one should feel pushed around by dogmatic and/or limited viewpoints, whether those of psychiatrists, anti-psychiatry advocates, or myself.




Grandiosity Extinguished

DioceseFire

When I returned from my Thanksgiving retreat, my spirits flew high. So much positive feedback had come my way during that weekend, it seemed to confirm my suspicion that my past has given me an outlook I should broadcast to the world. That grandiose intuition first ignited during my religious ‘visions’ ten years ago, and has waxed and waned ever since. Soon after the retreat I dove into a heartfelt poem, followed by a string of rambling essays about spirituality. In the throes of feeling ‘called’ to speak out, I envisioned myself becoming a bit of a celebrity, offering wisdom to the world. I did not see this coming notoriety as something my efforts had earned, or my ego devised, but as something handed to me by fate. Or ‘God’ if you want to look at things that way.

Would anyone be surprised to learn that the response to my spirituality posts has been underwhelming? Or that my rosy optimism has been replaced by a more jaded perspective?

The cold waters of reality have doused the flames of grandiosity. For one thing, I read the book ‘How to Write a Book Proposal’ by Michael Larsen. Browsing in the library, I wanted input about how to deliver my message to a large audience. The book offered lots of advice in that regard. Problem is, much of it sounds like it’s beyond my grasp. If one wants to be a messenger in today’s world, it takes more than sitting at a computer and writing. You start by joining Toastmasters, work to build your presentation skills, scramble for every opportunity to speak, network widely, join societies, offer workshops, etc. I have a friend who is doing all these things, and has done so for years. It is finally paying off, but it has been a mammoth effort, and in my most sober moments I have to admit it does not look like something I could accomplish.

To start, the basic necessity of hard work daunts me. Back when I slogged through medical school and residency, strenuous labor and long hours were second nature. But that was long ago. Nowadays a productive day sees me writing for four hours. Even that can’t be done all at once, or my neck pain builds to breathtaking extremes. If I manage four such days in one week, I am doing well. I’m just being honest here. I know it’s whining to complain of my inability to work. At least I have the luxury of living without a job, thanks to a good disability policy that kicked in as soon as I lost a surgeon’s earning potential. I am fortunate that my physical limitations and psychological vulnerability have not driven me into poverty. With that acknowledged, it is also true that becoming a person people flock to for insight requires a level of effort that I have not achieved in a very long time. Not to mention the professional socializing and cold introductions I’d have to master. I’m an introvert both by innate personality and as a result of an upbringing that taught me the safest approach to life is to hide under a bush.

The spiritual series will continue, though today is a break from all that. What I’m setting aside is the dream of widely dispersing my method for moderns to feel spiritual. Instead, this project will bolster my sense that life means something, but will only provide a bit of amusement for a few others. I hope to intrigue those who find my blog and are persistent enough to wend their way through my prose. But I fear that will be the extent of my voice. Not that this would be insignificant. I believe it to be a worthy pursuit, but it will not improve many lives. I have not completely discarded the ambition of building a larger audience, but right now that seems unlikely.

This dose of reality leaves me free to ask what it is I most enjoy writing. Is it memoir? Is it philosophy? Is it ranting against pharmaceutical malfeasance? If the audience will remain small no matter what I choose to say, then why not say what gives my heart wings? And that, of course, is what I’ve done with this site all along.

Did my bout of grandiosity rise to the level of clinical mania? My sleep suffered, and I’d have gotten almost none without Ambien. The pace of my speech accelerated. My grip on the reality of my limitations relaxed. I opened to others in unprecedented ways, and if I had not been married might have pursued a fling. On the other hand, I did nothing impulsive. Did not spend unwisely, did not have an affair, did not gamble, did not drink. My behavior remained more or less acceptable, though I displayed more emotion at the retreat than normal for a fifty-year-old man. But isn’t that one of the points of retreats, to open up?

Why am I tempted to make a mood swing into an illness? Probably because it would make me feel less uncertain of ‘me.’ If I could ascribe my recent excitement to a disease separate from my core person, I would not be left asking what’s wrong with me. I would not have to puzzle over who this person is that can be silent, withdrawn, and discouraged one day, and voluble, intimate, and excited the next. But cutting myself off from the loopy side of my personality would be a copout. Better to embrace my occasional quirky behavior and soaring ambitions. Even if I fail to rescue the world from its rigidity and insistence on limiting the human mind, I can at least be me. I can be a person with turbulent emotions, passionate dreams, and creative visions. I can continue my efforts to combine logic with lyricism. It may be that others will see me as odd. Or maybe it’s only me that does. Either way, I can love myself, be happy I differ from the norm, and speak up. Isn’t that one of the goals of life, after all? To be ourselves, to be proud, and to give voice to our most heartfelt values?

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Insomnia, and other underrated forms of madness

brainasleepanatomy

One manifestation of my brain’s atypicality can be seen by tracking my sleep patterns. Over about a six day cycle, I regularly drift from spending about nine hours asleep to getting only three hours a night. It averages out to six hours per twenty-four, which is not bad, but it’s hard to maintain a sense of predictability and regularity with this pattern. Also, sometimes around 8:30 pm I feel worn out to the point that I can’t stop myself from going to bed early, but then I wake up after midnight, like I have now, and remain awake for four or five hours. After that I’ll go back to bed and (hopefully) sleep for another hour or two. Over the years I’ve tried many things to smooth out this roller-coaster, but to no avail. I don’t want to take sleeping medications 50% of the time, which is what I would need to avoid the three-hours-of-sleep nights. And if I try to stay awake when I’m tempted to tuck in early, I find my mood sinks so low that nothing gets done except sitting and brooding. Or watching TV and dozing off. Reading and writing just don’t happen when I feel that way.

I try to take advantage of the nights I don’t sleep. I write or study or meditate. If I’m at our Yosemite place, I may sit in the hot tub and marvel at the stars (so many stars up there in those primordially dark skies). Now that I take fewer psychiatric medications, I see that I need even less sleep. As humans age, some data suggests they tend to sleep fewer hours (there is better evidence that the proportion of time in REM sleep decreases). Since I started out not requiring much more than six hours, it’s beginning to look like I’ll end up needing only five.

What is sleep doing for us, anyway? In what I’ve read, and it’s not extensive, the answer is clear: no one knows.

One popular idea is that it helps consolidate memories. Experiments with sleep deprivation after certain types of learning tasks back this up. In particular Rapid Eye Movement (REM) sleep seems connected with acquiring new skills. When people sleep after learning complex tasks, brain imaging sometimes shows that the same regions are active during REM sleep as were active when the task was being practiced. This seems to suggest that REM is replaying the learned activity, presumably in order to fix it in the mind.

On the other hand, although facility at learning tasks (technically called ‘procedural memory’) associates with sleep, the ease of learning information (‘declarative memory’) does not. And even if REM helps some forms of memory formation, that does not explain the need for all the other stages of sleep (and there are several).

Although I like to understand the brain, I am happy that there remain so many mysteries. My suspicion is that this will be the case for a long time, possibly forever. The organ has such unimaginable complexity that figuring out what it does is truly daunting. Despite all that we’ve learned, we really don’t understand more than some superficial information like which areas demand more blood during which activities, or the types of neurotransmitters that mediate different brain functions. The fine details of how computation (a.k.a. thought) occurs remain quite obscure. Some basic facts have been established. For instance that information processing is modular. This means that incoming visual data get broken down into components such as depth, color, movement, and orientation in space. Each of these are handled by separate (though often adjacent) clumps of nerve tissue, and later recombined. But computational studies remain coarse in the level of activity they investigate: typically the combined signals of hundreds of simultaneously active cells.

In fairness to the brain science community, I am oversimplifying. Enormous amounts of research have been done. So much has been learned that I really have only vague estimates about how much is known. But I have a pretty good idea about what is not understood: i.e., most of what the brain does.

It is easy to get impressed with the volume of factual information about the brain that scientists have collected in the past one hundred years. But it is even easier (and more important) to get a sense of awe from the realization that despite all the millions of pages written about the brain, we really don’t know something as basic as why sleep evolved.

Psychiatrists, and those who consult with them, would do well to keep this in mind as they try to address complex personal issues (like excessive worrying, chronic sadness, or uneven sleep) by adding one or a few chemicals to the blood stream. These solutes reach every cell in the brain, and affect many, many more neurons than the ones ‘targeted’. And even in the cells the medications are meant to affect, the actions are varied and all too often transient. The brain is quite adept at restoring its native state (see my post on receptor downregulation).

Sometimes it is better to accept an atypical pattern, like wacky sleep cycles, than to wrestle the brain into normative behavior with drugs. Besides, there can be advantages. Like writing a post in the middle of the night, so tomorrow I can concentrate on the other work of blogging: reading what others write. Or maybe I’ll have time for more fun with Mandy and the dogs. Or a longer workout. If I gave in now and took a sleeping pill, I would spend a nice restful night in bed. But I would wake up tomorrow after too many hours asleep, and still feel groggy. And if I kept taking the pill night after night, pretty soon my sleep would be dependent on the drug. If I stopped it, I would face several nights of near-total insomnia before I got back to what my brain wants: a six day rotation between nine hours and three hours of sleep.

I don’t know what this says about my brain’s health. It would be easy to call the three-hour nights ‘hypomanic’. In fact, I used to live in fear of them, thinking that hypomania meant possible manic loss-of-control and/or inevitable subsequent depression. Now I find that is not true. Provided I always allow myself to sleep when I can, and make sure that even if I can’t sleep I get some time in bed resting and calming my thoughts, I do pretty well. I don’t find myself making horrible decisions, or getting pounded by despairing feelings of worthlessness and futility. Admittedly, in my life I have seldom had true manic episodes (maybe only one time, but it lasted 2 years and destroyed my life). So I don’t worry too much about completely ‘losing it’, and (for instance) gambling away my life savings. But I know some who do have more trouble with severe mania, who find they can manage it with less or no medication, provided they are diligent and committed to keeping things healthy. It helps to have a devoted and observant spouse.

Society exerts pressure on people to conform. That becomes obvious in grade school, and it never changes. The main body of humanity tugs hard on the fringes, trying to pull them into the huddled center. Deviance, or even disagreement, tend to be poorly tolerated. So those of us with brains that function ‘differently’ from the ones comfortably in the center of the bell curve have to contend with criticism, rejection, and pressure to take drugs. All are either indirect or direct efforts to get us to conform.

There are mental states that pose hazards. Particularly to the individual who suffers them (i.e., suicide), and more rarely to others (e.g., the family left bankrupt by a manic run to a casino, or the spouse broken-hearted by a string of impulsive and dangerous sexual liaisons). The tiny threat of physical violence against strangers (the ‘psycho’ murdering students with an assault weapon), gets a great deal of attention. But if we define wanton violence as pathological (which I’m not saying is a bad idea), then many heads of state should be diagnosed as ill. If we go a step further, and say all those with a propensity for needlessly harming others require pharmacologic therapy, then we really should have force fed George W. Bush with Seroquel.

I’m not saying that no one should get psychiatric medications. That is not my position. But it is all-too-clear they are overused, that they cause physical and mental anguish, and that they are not particularly effective (unless you count drugging someone into a slurred stupor a success). The pharmaceutical companies have had free reign to promote their product, and we need to rise up and apply counter-promotion to balance the scales.

insomnia

In a larger sense, it is vital that we stand against the shove of society, and reclaim our right to be different. The tension between those who demand absolute obedience to the dominant culture’s standards, and those who advocate diversity and creativity, is never ending. The first step is to recognize that this is the problem we face. We need to demand to be allowed to be different, and then accept help when we want it. Otherwise we get the current situation, where we are told we are sick, and have to refuse drugs at every turn.

I’ll be up for a while longer. I’ll edit this post, write a letter or two, and explore some of my fellow travelers’s blogs. I’ll appreciate this night of little sleep as a time for making up the lost ground that resulted from weeks of rocky moods while withdrawing from Cymbalta. I’ll be glad I’m different. I’ll claim my privilege to consider myself ‘better’ than the boring norm.

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Humorous tales of youth, and what I’d like to regain.

Photo taken by Mandy on a (recent) trip to Yosemite!

At age sixteen, I planned to hike the John Muir Trail with my friend Jack (not his real name, though why would it matter if the world learned about our teenaged foolishness 34 years after the fact?). I did eventually complete the trek, but a few glitches arose. The problems started after we rode a Greyhound bus north from Los Angeles. We boarded with a number of outdoorsy types just like us, carrying bulging backbacks and bota bags, who chatted the whole trip. There were mothers holding their small children on their laps, trying to calm them as they stood on mom’s jeans, riding to homes or relatives in small towns along the eastern Sierra slopes. One or two men in faded business suits sat near the back, a lonely type I always used to see on intercity rides. Are they salesmen? Fathers working away from their families? A contingent of older folks had also boarded; they shoved shabby suitcases overhead, and leaned against the windows to nap until Reno, saving their energy for the casinos. Like them, Jack and I slept most of the way, under the influence of pills I had borrowed from the medicine cabinet of an elderly woman whose garden I tended.

We awoke to disembark at Lee Vining, a minute hamlet close to Yosemite National Park and (coincidentally) not far from where I now sit. I swiped a bottle of rum from the local general store, being an ignorant but fearless young delinquent. Jack and I sat on the shoulder of the road with our spanking-clean packs, and shared the bottle down to its last swig. As we became more and more drunk (a process aided by the the Valium we’d taken on the bus) we kept our thumbs out over the road, until a young man in a yellow Porshe at last pulled over. The car looked new, and smelled like a shoe store with all its fresh leather. Jack, being smaller than me, squeezed into the cramped back seat, and I ‘rode shotgun’ in the shiny black passenger seat as we wound our way toward the high mountains. I don’t remember much of that drive to the trailhead. It must have taken over an hour, and we arrived after dark. Our benefactor abruptly dumped us with our backpacks on the side of the road. He had figured out right away that we were tanked (how hard could it have been?), and made it clear he regretted stopping for us. Although he may have picked us up to show off his new car, by the end he probably feared one of us would throw up on the carpet.

Wilderness at last! In the dark and moon-less summer night we looked around and marvelled at the narrow pines silhouetted against the stars, and the flat expanse that lay between us and the forest. Taking in the majesty of the mountains quickly got replaced by our exhaustion, bordering on coma. On the cliff’s edge of collapse, we decided that rather than thrash our way into the dark groves to set up camp, we’d do the easier thing and unroll our sleeping bags where we stood. Within minutes we were passed out in our bags. Funny thing, this cop car drove by and blasted us with a searchlight. I vaguely remember their P.A. system barking something about moving our camp site. It did not sound like a bad idea, but it would have been a lot of work. So we fell back asleep instead. As you might guess, that turned out to be a big mistake. When the police returned, they had little patience with our drunkenness. It also turned out we were camping in a parking lot, which was probably what tipped off the cops that we were not too sober. Within about thirty seconds they found the fifty joints of marijuana Jack had carefully concealed in his pack. Uh oh.

For the next ninety minutes we slammed from side to side in the back of a cold steel-walled van, trying to stay perched on the single steel bench. Hands cuffed behind us, we had little chance of holding on as the vehicle roared down the twisting road toward Yosemite Valley. Once we arrived the two officers, already divided into the good-cop/bad-cop routine that I learned about later, shined intense flashlights in our eyes and told us to get out. Dizzy from the drive and the booze, and blinded by the glaring white beams, we tumbled out of the wagon and more or less landed face-first on the oily asphalt. As the cops chuckled, we writhed our way to standing positions, hands still pinned behind us. They marched is in to the little jail, and spent most of the night interrogating us. What they hoped to get out of two high school kids is a mystery still, but early on I confessed the location of the rest of the drugs. I should have kept my mouth shut, since I doubt they would have found the stash otherwise. They thought everything had already been located, and their search of my pack had been cursory. But the ‘good cop’ won my trust, and I decided to help him out. Their whole attitude changed after I fessed up. Both became cold and all business, and they went through every last rolled-up sock. By the time they unlocked our hands and pushed us into the four bed cell, the pleasant stupor of near-lethal intoxication had long-since worn off. As I lay on a one-inch thick mattress staring at the underside of the upper bunk, with the corridor lighting making the room almost as bright as day, the depressing fact of our arrest for marijuana possession began to sink in. I had ample time to contemplate this giant screw-up, and what looked like the end of the John Muir Trail adventure.

How stunning the view from the front steps of Yosemite Jail! Few lock-ups let you out into a plunging chasm lined by vertical granite, with a thousand-foot-high waterfall thundering to your right as you stagger down the redwood stairs. The photo with today’s post, taken recently, reminds me of what a glorious sight opened before me as I exited the jail. Sadly, Jack’s parents were not enjoying the vista. After driving most of the night from an L.A. suburb, they seemed a bit peeved. They hammered Jack with their anger and accusations, once in a while staring at me, eyes almost bleeding with contempt. This was not fun for any of us. Jack and I had been strictly ordered to depart the park and not return for at least a month, if ever. Jack’s folks led us to their car like executioners loading horse thieves into a gallows-bound carriage. I worked to reinforce my defences for a drive south under a barrage of criticism, but before we took off my father granted a reprieve. We spoke for the first time since the arrest as I stood at a phone booth under an enormous cedar, the morning air pungent with a scent of damp pine needles. I gazed with longing across a vast meadow the color of limes, toward sheer rock faces that loomed above me despite the distance. My father could not be predicted under even normal circumstances, so I had no idea what to expect as I told him the story. Since the police had been unable to reach him the night before, I was free to slant things to make my behavior sound pretty innocent. Those arrogant park rangers had rousted us as we slept, just to harrass us. It must have been our long hair that made them decide to frisk us. They had no probable cause. I thought it best to leave out the parts about camping in the parking lot, or how we were so stoned we could barely talk. Knowing how furious it would make my stepmother if I ruined her summer by returning to L.A., my dad only surprised me a little when he suggested I stay in the mountains. “Keep a low profile,” he directed after I told him how the rangers had banned me for thirty days. Why not just leave the park via the trail, and commence backpacking by myself? The drugs had been confiscated, so he did not see how I could get into any more trouble. (Six weeks later I would talk to him from inside the Fresno County Juvenile Detention Facility.)

Sounded good to me. With a widening smile, I pulled my disheveled and ransacked pack out of the family car’s trunk, said goodbye to a brooding Jack and his fuming parents, and trudged off into the trees. I moved quickly, before any cops noticed I wasn’t rolling out the gate. The next two weeks gave me my first taste of adult freedom. Friendships formed easily among the shaggy young drifters hanging out in the walk-in campground (no cars allowed). With our down sleeping bags stretched out on beds of pine needles, reminding me a bit like a field of body bags (even then I tended toward morbid reflection), we slept in an open grove of ancient conifers. We all wore the same uniform: plaid cotton shirt and blue denim jeans. We ate Fruit Loops cereal for breakfast, and then broke into groups to hike, or ride the open-air trams, or maybe swim in the freezing currents of the Merced River swollen with snow-melt. We drank lots of booze, once or twice ‘dropped’ LSD, smoked pot day and night, ate slices of pizza outside the Yosemite Valley store, and pretty much created a ruckus wherever we went. Every day I got an adult to buy me a half-gallon of cheap chablis, which I passed around the campfire with my new pals. That helped get me past the obstacle that as a high school kid I was the youngest and most naive of this group of youths. Most of the girls I met in the park seemed far older than me (e.g., the advanced age of nineteen), or else they were my age but kept on a tight leash by their parents or chaperones. I lucked out, however, and managed to spend one whole night with a college-bound girl I’d met that afternoon, but in my nervousness I drank so much I passed out with my clothes on. She still seemed to like me when we awoke the next morning, fully clothed but wrapped in each other’s arms. To my chagrin, she left the park that day with her tour group. So much for my hopes of ditching my virginity in Yosemite.

I struck up a friendship with a guy named Paul, who had no fixed address and worked odd jobs when he needed cash. He latched onto the John Muir Trail idea like a tick on a poodle, and we started collecting food for the first leg of the walk. He taught me that dried pasta, pankcake mix, Lipton soup packs and dry salami fed you just as well as pricey freeze-dried dinners. He helped me get rid of useless items, and employ the extra space in my pack for more food, so we could go further before restocking. He showed me that you can burn a camp stove on unleaded gasoline from a service station (back then they sold gas in Yosemite Valley, and unleaded fuel was still a novelty), which was cheaper than the less toxic white gas available in supply stores. Paul made me realize that Jack and I would have smacked into problems soon after starting, we had arranged things with such ignorance. Shorter than me, but stocky, Paul’s curly hair was so blonde it looked almost white. He only shaved often enough to keep the stubble from turning into a beard. HI thought he seemed worldly and street-smart. I called my dad and told him I was finally launching my adventure. To my surprise, he cautioned me to be on my guard with my new friend. A few weeks later I found out he had given me good advice.

One morning we pulled our weighty packs up on our shoulders, cinched the waist straps, and embarked on the 211 mile trail. The first day we spent climbing out of Yosemite Valley, past the roar of Vernal and then Nevada falls. Each is a thundering wall of white water, and kicks up a cloud of mist that drifts over the trail to either freeze or refresh you, according to the day’s weather. Above and below them both, the river drops almost as steeply as the falls themselves. I took all thin in on a trail that started out crowded with visitors, so that we had to squeeze by balky children, or stomp impatiently behind older couples breathing in heavy sighs as they made the ascent. But when we reached the Valley’s rim the numbers dropped off sharply. The terrain opened out into large expanses of granite sparkling with feldspar, and the melt-swollen stream feeding the two falls swirled in vigorous currents next to the trail. The river swept along through a narrow sluice that a glacier must have carved into the massive blocks of stone that formed the mountain, and moved so fast I could not see any living thing in the water.

This story forms a diptych, and one main panel of it happened as I attempted to cross the granite sluice through this muscular flow. For today, I want to skip ahead to the first night Paul and I spent on the trail. We set up camp in a grove of conifers stunted by poor soil layered on top of a hard pan of rock. That evening, as we sat with a Boy Scout troop around a small campfire (back then hikers were still allowed to burn open fires). We hear a loud thrashing in the forest, and by the light of the blaze I detected a bulky shadow under the tree where I had suspended my sac of food. We all stood up, but only I rushed into the grove to find that my bag, and only mine, had been swiped by a bear. I had dutifully suspended it from a branch, but underestimated the reach of a bear extending on its haunches. A chronic petty thief, I suppose it served me right to get robbed by a wild animal. But it did not bode well for the success of my trip if I ran out of food in the first twenty-four hours, especially if it wasn’t me that consumed it.

I was young. I was stupid. I took off after the lumbering bear. It looked like it moved slowly, but that illusion came from its gigantic size. The animal’s gallop rapidly outstripped me as I sprinted and screamed and threw rocks. The moon was full by this time, two weeks after the dark night when Jack and I camped in the parking lot. So I dashed through the open forest in pursuit of the bear’s gigantic contour which I only glimpsed now and then, screaming at full volume. Somewhere along the way I pulled a thick branch into my hands, and I brandished it like a baseball bat. If I had caught the bear, if it had waited for me or headed back my direction, I would have swung that branch at its head. That probably would have been my last living act. Luckily for me, after the bear paused to rip open the sack and rummage its contents, it loped on again and disappeared into the granite masses that surrounded us. Out of breath after the chase, I stopped when I spotted my food containers and torn ‘stuff sac’ scattered on an open face of rock the size of volleyball court. I gathered up my items. A can of spam had been punctured by the bear’s fangs. The box of pancake mix was ripped, and seemed a bit damp with slobber, but still held most of the powder. Cans of evaporated milk had rolled into crevices unharmed, but the beast had ripped open my box of brown sugar, and licked out every single crystal. And I never saw the dried salami again.

Why did I take the time to put this really long story on my blog? Especially when I know that few people have enough interest to read all the way through such lengthy posts. As I said, this tale actually forms part of a diptych. The second part is short, and tomorrow or soon after I will publish it on the site. Both anecdotes show my courage as a teenager, and how blind I was to my own vulnerability. I suspect young soldiers at war have similar ‘bravery’. Generals count on their troops to act with little caution when engaging the enemy. I would have done well in a war, until my brashness got me killed.

I am different now. Very timid about risk, and ever-mindful of consequences. One advantage of my former bouts of hypomania, which medications no longer allow me, is that I would lift my blanket of caution. I would recover some of my adolescent wildness, and its creative impulses. As I pull myself out of my decade-long pit of despair, I want to recover some of that bravery. I’d like get reacquainted with that young man, who chased a three hundred pound fanged and clawed wild animal through a moonlit forest. Who never worried that the bear could have sliced his gut open with a swipe of its paw. Stupid, yes. But also bursting with vitality. Better to be alive in one’s heart and a bit foolish, than be dead in one’s soul and ever-so-wise.

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